Factors associated with hepatocellular carcinoma in Hepatitis C

Factors associated with hepatocellular carcinoma in Hep C

March's issue of Gut investigates maintenance peginterferon therapy and other factors associated with hepatocellular carcinoma in Hep C.

Interferon reportedly decreases the incidence of hepatocellular carcinoma in patients with chronic hepatitis C.

The Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial showed that 4 years of maintenance therapy with pegylated interferon (peginterferon) does not reduce liver disease progression.

Dr Anna Lok and colleagues investigated whether peginterferon decreases the incidence of hepatocellular carcinoma in the HALT-C cohort over a longer posttreatment follow-up period.

The research team evaluated 1048 patients with chronic hepatitis C who did not have a sustained virologic response to therapy.
In treated patients, incidences were 8%
Gastroenterology

The patients were randomly assigned to groups given a half-dose of peginterferon or no treatment for about 4 years, and followed up for a median of 6 years.

The researchers found 88 patients who developed hepatocellular carcinoma.

The team reported that these patients included 37 of 515 who were given peginterferon, and 51 of 533 controls.

There was a significantly lower incidence of hepatocellular carcinoma among patients given peginterferon therapy who had cirrhosis, but not fibrosis, based on analysis of baseline biopsy samples.

The team found that after 7 years, the cumulative incidences of hepatocellular carcinoma in treated and control patients with cirrhosis were 8% and 24%, respectively.

In treated and control patients with fibrosis, incidences were 8% and 7%, respectively.

Treated patients with a 2 or more point decrease in the histologic activity index, based on a follow-up biopsy, had a lower incidence of HCC than those with unchanged or increased scores.

Dr Lok's team concludes, "Extended analysis of the HALT-C cohort showed that long-term peginterferon therapy does not reduce the incidence of hepatocellular carcinoma among patients with advanced hepatitis C who did not achieve sustained virological response."

"Patients with cirrhosis who received peginterferon treatment had a lower risk of hepatocellular carcinoma than controls."


Gastroenterol 2011: 140(3): 840-84914 March 2011